Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices 37387

and consistent with the intended use of

the funds. Extent to which the budget

includes itemizations, justifications,

scope, and deliverables for consultants

or contractors.

H. Other Requirements

Technical Reporting Requirements

An original and two copies of semiannual progress reports are required.

Timelines for the semi-annual reports

will be established at the time of award.

Final financial status and performance

reports are required no later than 90

days after the end of the project period.

All reports are submitted to the Grants

Management Branch, CDC. At the completion of 2 years of

funding, recipients will be expected to

share prevention packages with

representatives of the original agencies

that conducted the interventions on

which the products are based, if

different from those of the recipient.

The following additional

requirements are applicable to this

program. For a complete description of

each, see Attachments.

AR98–1 Human Subjects

Requirements

AR98–2 Requirements for Inclusion of

Women, Racial and Ethnic

Minorities in Research

AR98–4 HIV/AIDS Confidentiality

Provisions

AR98–5 HIV Program Review Panel

Requirements

AR98–7 Executive Order 12373

Review

AR98–8 Public Health System

Reporting Requirements

AR98–9 Paperwork Reduction Act

Requirements

AR98–10 Smoke-Free Workplace

Requirements

AR98–11 Healthy People 2000

AR98–12 Lobbying Restrictions

I. Authority and Catalog of Federal

Domestic Assistance Number

This program is authorized under

sections 301 and 317(k), of the Public

Health Service Act [42 U.S.C. 241 and

247b], as amended. The Catalog of

Federal Domestic Assistance number is

93.941.

J. Where to Obtain Additional

Information

To receive additional written

information, call (888) 472-6874. You

will be asked to leave your name,

address, and telephone number. Please

refer to Program Announcement 98098

when you request information. For a

complete program description,

information on application procedures,

an application package, and business

management technical assistance,

contact: Maggie Slay Warren, Grants

Management Specialist, Grants

Management Branch, Procurement and

Grants Office Announcement 98098,

Centers for Disease Control and

Prevention (CDC), Room 300, 255 East

Paces Ferry Road, NE., M/S E–15,

Atlanta, GA 30305–2209 telephone

(404) 842–6797. Email address http://

www.MCS9@CDC.gov

See also the CDC home page on the

Internet: http://www.cdc.gov

For program technical assistance,

contact: Robert Kohmescher, Division of

HIV/AIDS Prevention, National Center

for HIV/STD/TB Prevention, Centers for

Disease Control and Prevention (CDC),

1600 Clifton Road, NE., Mailstop E–44,

Atlanta, GA 30333 telephone (404) 639–

8302 email: www.rnk1@cdc.gov

Please refer to Announcement number

98098 when requesting information and

submitting an application.

Dated: July 6, 1998.

John L. Williams,

Director, Procurement and Grants Office,

Centers for Disease Control and Prevention

(CDC).

[FR Doc. 98–18389 Filed 7–9–98; 8:45 am]

BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Administration for Children and

Families

[Notice of Program Announcement No.

ACF/ACY/CB–98–05]

New Child Welfare Demonstration

Project Proposals Submitted by States

for Waivers Pursuant to Section 1130

of the Social Security Act (the Act);

Titles IV–E and IV–B of the Act; Public

Law 103–432

AGENCY: Administration for Children

and Families, HHS.

ACTION: Notice.

SUMMARY: This notice lists new

proposals for child welfare waiver

demonstration projects submitted to the

Department of Health and Human

Services pursuant to the guidance

contained in Information Memorandum

ACYF–CB–IM–98–01 dated February

13, 1998, public notice of which was

given in the Federal Register of March

4, 1998, Vol. 63, No. 42, page 10637.

COMMENTS: We will accept written

comments on these proposals, but will

not provide written responses to

comments. We will neither approve nor

disapprove any new proposal for at least

30 days after the date of this notice to

allow time to receive and consider

comments. Direct comments as

indicated below.

ADDRESSES: For specific information or

questions on the content of a project or

requests for copies of a proposal, contact

the State contact person listed for that

project.

Comments on a proposal should be

addressed to: Michael W. Ambrose,

Administration on Children, Youth and

Families, Children’s Bureau, 330 C

Street, SW, Mary E. Switzer Building,

Room 2058, Washington, D.C., 20201.

FAX: (202) 260–9345.

SUPPLEMENTARY INFORMATION:

I. Background

Under Section 1130 of the Social

Security Act (the Act), the Secretary of

Health and Human Services (HHS) may

approve child welfare waiver

demonstration project proposals with a

broad range of policy objectives.

In exercising her discretionary

authority, the Secretary has developed a

number of policies and procedures for

reviewing proposals. The most recent

expression of these policies and

procedures may be found in the

February 13, 1998 Information

Memorandum cited above, a copy of

which may be found at the ACF website

at http://www.acf.dhhs.gov/program/cb/

demonstrations or may be obtained from

the National Clearinghouse on Child

Abuse and Neglect Information, (800)

394–3366, internet address

<nccanch@calib.com>. We are

committed to a thorough and

expeditious review of state proposals to

conduct child welfare demonstrations.

II. Listing of New Proposals

As part of our procedures, we are

publishing a notice in the Federal

Register of all new proposals. This

notice contains summaries of 17

proposals received by April 30, 1998.

Each of the proposals contains an

assurance that the proposed

demonstration effort will be cost neutral

to the federal government over the life

of the proposed effort; and each

proposal contains an evaluation

component designed to assess the

effectiveness of the project.

State: Arkansas

Description: The State of Arkansas

proposes to use title IV–E funds to

enhance mental health services

available for children in foster care and

children at risk of being placed in foster

care, and thereby reduce barriers to

permanency for those children. The

State intends, in October, 1998, to

implement a system for mental health

managed care for all title XIX eligible

children, and all children in DCFS

foster care. Under this demonstration,

the State would use title IV–E funds to
37388 Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices

provide supplemental payment to the

managed care capitated rate to (1) allow

for previously unallowable services to

title IV–E eligible children (Managed

Care component); (2) provide

specialized, collaborative case

management services to a group of

randomly selected foster children (some

of whom may not be IV–E eligible) and

children who are at risk for being placed

in foster care because of their service

needs, to identify and address barriers

to permanency (FOCUS component);

and (3) provide training to child welfare

staff as well as others in the community

to enhance participation in the project

from agencies and persons outside

DCFS.

Arkansas proposes to conduct a

process evaluation as well as an

evaluation to produce outcome data,

and a cost/benefit analysis. The

evaluation design for the collaborative

case management services portion of the

project is proposed as a design based on

random assignment of children or

families to treatment or control

conditions.

The State requests waivers of title IV–

E to allow the State to conduct a portion

of the Demonstration on less than a

Statewide basis, to allow the State to

expend title IV–E funds for children and

families who are not normally eligible,

to allow the State to make payments for

services that are not normally covered

under Part E of title IV of the Act, and

to allow the State to expend title IV–E

funds for training of persons who are

not normally eligible. The State also has

requested a title XIX waiver under the

authority of section 1915(b) of the Social

Security Act to establish a mental health

managed care system to reduce costs,

prevent unnecessary and inappropriate

utilization, and ensure access to quality

mental health care for Medicaid

recipients.

Contact Person: Lee Frazier, Director,

Arkansas Department of Human

Services, 329 Donaghey Plaza South,

P.O. Box 1437, Little Rock, Arkansas

72203–1437, Phone: (501) 682–8650,

Fax: (501) 682–6836.

State: Connecticut

Description: Connecticut’s proposal

has two distinct program components.

The first proposes to use title IV–E

funds to implement a subsidized

guardianship program and to change

case work practice to provide increased

emphasis and support for guardianship

as a viable permanency option for cases

where reunification or adoption of

children living with relative care givers

is neither appropriate nor feasible. The

second component proposes to conduct

pilot demonstrations of a service

delivery model in which a single lead

agency would organize, manage and

provide an array of services to address

the specific needs of children who

require placement in residential or

group homes.

The goal of the proposed

guardianship program is to provide

another means of attaining permanency

for children who would otherwise

remain in foster care. The program

would be implemented state-wide and

would focus on children residing with

relative caregivers. It would provide: (1)

A monthly subsidy on behalf of the

child payable to the guardian equal to

the prevailing appropriate foster care

rate; (2) a medical subsidy comparable

to the medical subsidy for subsidized

adoption (if the child has no private

health insurance); and (3) a lump sum

payment for one-time expenses resulting

from the assumption of care for the

child (when other resources are

unavailable). Waivers would be required

to allow for Federal IV–E

reimbursement for payments to relative

caregivers when a child leaves legal

custody of the State agency, and for

program administration and services

that are not currently allowable under

IV–E.

The proposed ‘‘single contact/

continuum of care’’ program’s goal is to

test the effectiveness of the service

delivery model in which the State’s

Child and Family agency (DCF) would

contract with a single Lead Service

Agency that would manage subcontracts

and create an expanded network of

regular and specialized services for

children and youth with behavioral

problems who are referred to residential

or group homes.

The State hypothesizes that this

demonstration project would decrease

the length of stay in restrictive settings;

increase treatment options for children

and families; improve permanency

outcomes for children and provide longterm stability in the community; and

establish a more flexible, incentiveoriented fiscal environment for service

providers. One or two pilot programs

would be established to serve 30

children per pilot over a five year

project period. The program would be

targeted to DCF children aged 7 to 15.

A 15 month service period, which

includes a minimum of 3 months of

aftercare, is projected for each child.

Waivers are requested to allow the

administrative and services costs to be

IV–E reimbursable.

Contact Person: Robert Dakers,

Department of Children and Families,

505 Hudson Street, Hartford, CT 06106–

7107, Phone: (860) 550–6542, Fax: (860)

566–7947.

State: District of Columbia

Description: The District of Columbia

proposes to test the ability of a

partnership between the Child and

Family Services Agency (CFSA) and

neighborhood-based community

collaboratives to improve service

delivery for children in kinship

placements. Teams of CFSA social

workers matched with trained

collaborative community workers would

provide family preservation services to

the kinship triad: the kinship caregiver,

the parent and the child. CFSA

hypothesizes that this public-private

partnership would increase the number

of children who achieve permanency,

speed the permanency process, increase

stability in kinship care families,

increase outreach and education that

promotes child safety and reduce the

incidence of further abuse or neglect for

children and families receiving these

services, and reduce time in out-ofhome placements and the number of

new foster care placements.

To test its hypotheses, CFSA has

requested waivers to permit title VI–E

funds to be expended for services and

individuals that are not eligible under

existing law. The requested waiver

would allow the District to be

reimbursed for foster care services

provided to children who are not IV–E

eligible, including those who are living

with kinship caregivers, and to allow

adoption subsidy payments for children

who are not IV–E eligible.

The District’s proposed evaluation

design would randomly assign eligible

kinship triads to experimental and

control groups. The experimental group

would receive the team approach and

the control group would receive

traditional services from a social

worker. The evaluation would measure:

Changes in Child Safety through the

number of new allegations, allegations

after a case is closed, disruptions in

placement, entries or re-entries into

non-kinship foster care; Child WellBeing through the Child and Adolescent

Functional Assessment Scale; and Child

Permanency as indicated by adoption,

legal custody or re-unification.

Contact Person: Ernestine Jones,

General Receiver, Office of the General

Receiver, Child and Family Services

Agency, 900 Second Street, N.E., Suite

221, Washington, DC 20002, Phone:

(202) 842–0888, Fax: (202) 842–2335.

State: Florida

Description: Florida proposes to

demonstrate whether children and

families can achieve better outcomes

through: privatization, managed care,

and Medicaid therapeutic service
Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices 37389

integration. In response to a 1996

legislative mandate to private child

welfare services, the Florida Department

of Children and Families allowed

community-based providers to operate

five pilot projects. Waivers under a

demonstration project would enable

these providers to use State funds and

federal title IV–E funds to purchase

therapeutic services for children who do

not meet Medicaid ‘‘medical necessity’’

restrictions for therapeutic services. In

addition, at least one demonstration site

would receive a capitation payment

linked to the number of children living

in poverty. Each site would then utilize

this funding flexibility to reconfigure

services. The state hypothesizes that

this would expedite all aspects of

permanency, improve family capacity to

care for children, increase family

involvement and the range of supports

available to families, and increase

youths’ preparation for independence.

Florida proposes to compare the

performance of selected comparison

counties to the performance of the

demonstration counties. The State’s

evaluation design would include

outcome evaluation, process evaluation,

cost analysis and cost benefit analysis.

Outcome measures include safety and

protection, permanency goals, stability

and functioning and customer

satisfaction. Process measures would

examine policies, procedures, client

flow, staffing expertise and levels,

service types, duration, mix, timing and

accessibility, assessment processes, and

court, community and media

relationships. A cost analysis would

study all costs associated with the

project and comparison counties. The

cost-benefit analysis merges cost data

with outcome data to determine the

overall value of the outcomes.

Contact Person: Margaret Taylor,

Florida Department of Children and

Families, 1317 Winewood Boulevard,

Tallahassee, Florida 32399–0700,

Phone: (850) 922–0149, Email: Taylor

lMargaret@dcf.state.fl.us.

State: Iowa

Description: Iowa proposes to fund

community-based services to improve

outcomes for children and families in

the child welfare system using title IVE funds. The State plans to build on the

existing Decategorization Project areas

and Innovation Zones to increase the

capacity of local organizations to care

for children and families and build

service strategies for children and

families in the child welfare system.

The State believes this demonstration

would efficiently reduce the amount of

time children spend in out-of-home care

and move children into permanent

placements more quickly.

The State proposes to implement this

demonstration in several counties or

clusters and use a comparison group of

counties to evaluate both the impact and

the cost of using title IV-E funds

flexibly. Under the State’s plan,

counties would present proposals for

participating in the IV-E demonstration

that focus on: (1) Diverting children

from out-of-home care, including foster

care, group care, residential care, and

mental health or juvenile justice

institutions; (2) providing for

permanency for children quickly and

effectively; and/or (3) reducing re-entry

into out-of-home care. For each county’s

or cluster’s proposal, the State is

proposing that the eligibility

determination for title IV-E be

eliminated under the demonstration. To

assess the demonstration project, the

State proposes to compare

demonstration counties or clusters to

children in comparison counties or

clusters. The evaluation would produce

process, outcome, and cost/benefit

information.

The State is requesting waivers of

certain provisions of title IV-E which

would allow Iowa to: (1) Use title IV-E

funds to pay for additional services for

children and families; and (2) spend

title IV-E funds on children and families

who would not normally be eligible for

title IV-E.

Contact Person: Mary Nelson,

Division Administrator for Adult,

Children and Family Services, Iowa

Department of Human Services, Hoover

State Office Building, Des Moines, IA

50319–0114, Phone: (515) 281–5521,

Fax: (515) 281–4597.

State: Kansas

Description: Kansas proposes to fund

a demonstration project intended to

‘‘support and enhance’’ the new

performance-based administration of the

Kansas Child Welfare System. The

Kansas Department of Social and

Rehabilitation Services (SRS) intends to

conduct a multi-faceted project

consisting of a subsidized guardianship

program, integrated child welfare

training, enhanced drug/alcohol

services, and subsidized family

reintegration upon return home

(aftercare). In addition, the initiative

would compare the new case rate,

performance-based payment system

(already in place statewide) with the

traditional fee-for-service payment

system in order to determine which

payment method produces better

outcomes.

The State hypothesizes that: (1) The

subsidized guardianship project would

facilitate the permanency of children

when adoption and reunification with

their family is not feasible; (2) an

integrated child welfare training project

for private and public social service

professionals aimed at supporting an

integrated social service model with a

‘‘single worker per family’’ concept

would provide social service staff with

the tools needed to meet the needs of

families, including preventing out-ofhome placement; (3) a strengthened

approach to drug and alcohol

dependency assessment and treatment

planning directed to IV-E eligible

children and families would decrease

the number of disruptions to placement

and decrease the length of stay in outof-home placement; and (4) a project

making resources and services such as

respite care, family support services,

parenting education, family, individual,

and group therapy, available to families

upon reintegration of a child would

prevent further disruption.

The proposed evaluation design

would compare the fee-for-service

delivery system to the case rate

performance based delivery system.

Since the SRS has already shifted all of

the adoption and foster care delivery

systems into the latter, it would be

necessary to randomly select children to

be placed ‘‘outside the case rate.’’ The

random selection process would be

applied to selected area offices which

collectively represent 40% of the

children served, and three of the five

foster care regions. The State would

measure outcomes such as amount of

time for children to be placed with

adoptive families, percentage of

finalized adoptions within 12 months,

disrupted placements, number of

siblings placed together, number of

placement changes, new substantiated

claims of abuse or neglect, percentage of

children placed within Regional

boundaries, percentage of children

returned to family or achieving

permanence, re-entry into foster care,

percentage of children achieving

permanency and family satisfaction

with services.

The proposed project would be cost

neutral and would run for five years.

Contact Person: Teresa Markowitz,

Commissioner, Kansas Department of

Social and Rehabilitation Services, 915

SW Harrison Street, Topeka, Kansas

66612, Phone: (785) 368–6448, Fax:

(785) 368–8159, Email:

tamasrcfs.wpo.state.ks.us.

State: Maine

Description: Maine proposes a twophase demonstration project. The first

phase would involve the design and

implementation of an adoption training
37390 Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices

curriculum for mental health

professionals and other service

providers who would become expert in

working with families in need of postadoption services. The second aspect of

the demonstration would phase in the

purchase and delivery of post-adoption

support services for families who adopt

special needs children. The overall

goals of the project are to increase the

number of special needs children who

are adopted and to decrease the number

of disrupted adoptions. It is the State’s

hypothesis that increasing the array of

supportive services available to families

who elect adoption would promote

family stability and reduce disruptions,

as well as encourage other community

members to consider adopting children

with special needs. The State has

proposed a five-year demonstration

period.

The demonstration would be

conducted in four test sites, two urban

and two rural, from among the

Department of Human Services district

offices. At present, Maine has about 535

IV–E eligible children free for adoption.

The evaluation design calls for

establishing a control and experimental

group in each pair of selected sites, i.e.,

one urban control, one urban

experimental, one rural control and one

rural experimental. The State expects

that a total of 200 children and families

(100 control and 100 experimental)

would participate in the study over the

life of the demonstration. The

experimental group would receive the

expanded post-adoption services, while

the control group would receive the

current service mix.

Outcome measures would include the

number of special needs adoptions, the

incidence of disrupted adoptions, the

average length of stay in foster care and

the stability of the adoptive families.

Waivers are requested to enable the

State to use title IV–E funds to provide

services which are not normally allowed

under title IV–E Adoption Assistance or

title IV–E Foster Care.

Contact Person: Dawn Stiles,

Department of Human Services, State

House Station #11, Augusta, Maine

04333, Phone: (207) 287–5060, Fax:

(207) 287–5282, TDD: (207) 287–4479.

State: Mississippi

Description: Mississippi proposes to

expand the use of title IV–E funds to

non-IV–E eligible children and families

and to use title IV–E funds for any items

or activities that would eliminate or

reduce harm to children and families.

The demonstration proposes to

implement a Child-Focused Family

Centered Practice Methodology, which

emphasizes the safety and best interests

of children through the elimination of

harm-causing factors. The proposed

project involves using title IV–E funds

to provide services for children and

families whether children are in State

custody or not, including children in

residential care. This project would

involve the identification of services,

the development of a service delivery

system, the development of a business

plan, the building of multi-disciplinary

case management teams, and ongoing

evaluation and program modification. It

is the State’s hypothesis for the

demonstration that the expenditure of

funds to benefit any child, regardless of

IV–E eligibility, to reduce or eliminate

factors that cause harm to that child,

would demonstrate a reduction in harm

to children. The demonstration would

result in safer children due to the

reduction of harm to children who are

a part of the demonstration. The State

has proposed a five year demonstration

period. The demonstration would be

conducted in eight selected counties,

which are located in two Division of

Family and Children’s Services’ (DFCS)

regions.

The State proposes an evaluation

design in which eligible children and

families would be randomly assigned to

experimental and control groups. The

experimental group would receive a

combination of existing or modified

services along with newly created

services. The control group would be

served by the existing services only. The

evaluation would compare results from

the experimental group and control

group. Outcome measures include:

decrease in the proportion of children

who experience subsequent abuse or

neglect; increase in the proportion of

children who remain permanently with

their parental family; among those

children placed outside of their parental

home, increase in the proportion who

are in placements in the community of

their parental family and who are

placed with relatives; decrease in the

proportion of children placed in foster

care; decrease in the average number of

placements for children in foster care;

decrease in the amount of time spent in

foster care; an increase among children

awaiting adoption in the proportion of

children adopted and the speed of the

process; where two or more siblings are

placed outside of their parental home,

increase in the proportion of sibling

groups where siblings are placed in the

same setting; and increase in the wellbeing of children.

Waivers are requested to allow the

State to use title IV–E funds for children

and families who are not normally

eligible under title IV–E and to use title

IV–E funds, including funds which

would be reimbursed as costs of

administration, for the provision of

services.

Contact Person: Henry Goodman,

Department of Human Services, 750

North State Street, Jackson, Mississippi

39202, Phone: (601) 873–6144, Fax:

(601) 359–4477.

State: Montana

Description: Montana’s Department of

Public Health and Human Services

(DPHHS) is requesting approval of a

Child Welfare Demonstration Project,

which would allow title IV–E funds to

be used for a subsidized guardianship

program. The demonstration would

authorize a subsidized guardianship

program for eligible children; provide a

monthly guardianship subsidy,

Medicaid and non-recurring costs

associated with establishing legal

guardianship, and provide federal

financial participation in the costs of

administration and training associated

with the guardianship program.

Montana postulates that guardianship

provides the child and family a legally

recognized relationship, increases the

sense of family by granting the

caretakers in the family the right and

responsibility to make important

decisions regarding a child in their

home, provides a more stable placement

than does long term foster care and is

less costly, due in part to a reduction in

the administrative costs associated with

foster care. The demonstration project

would be statewide, for five years, and

would include children on the state’s

seven reservations. The project would

serve children 12 years old or older and

would mirror the adoption assistance

program as much as possible. The

project is expected to be cost neutral.

Comparison of the costs associated with

the demonstration group and the control

group will be used to determine the

fiscal effect of the demonstration.

The Montana DPHHS is also

considering joining a consortium of

states in Region VIII, which would seek

to demonstrate the impact of allowing

IV–E funds to be provided as a direct

pass through of federal funds to one or

more tribes in Montana and in each of

the other consortium States.

The State requests waivers to allow

title IV–E funds to be used for children

who are not IV–E eligible and for

services which are not ordinarily

reimbursable under title IV–E. The

DPHHS intends to use random

assignment of children to either a

service or a control group, and will use

an independent contractor to conduct

the required evaluation.

Contact Person: Hank Hudson,

Administrator, Child and Family
Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices 37391

Services Division, Department of Public

Health and Human Services, State of

Montana, P.O. Box 8005, Helena,

Montana 59604–8005, Phone: (406)

444–5900, Fax: (406) 444–2547.

State: Nebraska

Description: The Nebraska Health and

Human Services System proposes to test

local approaches to child welfare system

change through a demonstration project.

It is the State’s hypothesis that the

combination of flexible use of title IV–

E funds and local integrated networks

would: (1) Promote positive social and

health outcomes and prevent negative

outcomes for children and families; (2)

improve the well-being of children who

are at risk of, or actually require out-ofhome placement; and (3) improve the

family functioning and participation of

child welfare involved families. The

project would involve entities across the

State, including three which have

existing relationships with the State

system, by forming local integrated

networks to facilitate a better use of

resources. The State would provide

technical assistance, support and

expectations for systems management.

The effort is part of an ongoing Network

Development Strategy that is being

implemented Statewide.

The state estimates that a total of

3,240 children would be served through

the demonstration project. Each site

would utilize the flexible funds

differently, so the outcome measures for

each would be different. Sites are

expected to use the waiver authority for

purposes which include: promoting the

wraparound process for each child and

adolescent at high risk of out-of-home

placement; focusing on communitybased prevention, intensive communitybased services, community reintegration of out-of-area high-needs

children, and child and community

safety and community ownership by

developing a Managed Care Child

Welfare system in the third year of the

project; sustaining and enhancing the

local service network, increasing

parental, family and civic involvement,

co-locating staff and integrated services,

expanding choice and opportunities,

and increasing communication and

networking.

Nebraska is requesting waivers of title

IV–E to permit reimbursement for

expenditures made on behalf of children

who are not IV–E eligible, and for

purposes that do not ordinarily qualify

for reimbursement under IV–E.

The State proposes to compare the

demonstration sites with geographical

areas that do not have flexible use of

funds. The State would examine child

safety, permanence, child and family

well-being and community safety and

responsibility outcomes.

Contact Person: John Mader, Program

Specialist, Protection and Safety

Division, Nebraska Health and Human

Services System, 2345 North 60th

Street, Lincoln, NE 68507, Phone: (402)

471–9364, Fax: (402) 471–9034,

Email:john.mader@hhss.state.ne.us.

State: New Hampshire

Description: New Hampshire proposes

to use title IV–E funds to hire a

substance abuse specialist with

expertise regarding child protective

services who would conduct substance

abuse assessments of parents where

alcohol or other drug abuse is believed

to be a factor contributing to the child’s

abuse or neglect. For those families in

need of ongoing services, this staff

person would also assist them in

accessing intensive, community based

substance abuse treatment services. It is

the State’s hypothesis that the provision

of these immediate, targeted and

intensive services would enable families

better to provide a safe, nurturing

environment for their children, resulting

in the prevention of placement or a

reduction in the length of time children

remain in out-of-home care. The State

has proposed a five year demonstration

period.

The demonstration would be

conducted in two District Offices of the

State’s child welfare agency: those

located in Manchester and Nashua.

December 1997 statistics showed 245

children in foster care in these districts

who were IV–E eligible. Of these, 56%

had caretakers in which substance abuse

was a factor in their maltreatment.

The State proposes an evaluation

design in which eligible families would

be randomly assigned to experimental

and control groups. The experimental

group would receive the services of the

substance abuse specialist while the

control group would receive the current

services mix. Outcomes for each group

would be tracked. The State would

examine outcomes including placement

prevention, more timely reunification,

more timely alternate permanency

planning for children unable to return

home, and cost savings as a result of

improved permanency planning. The

State expects approximately 120

children in the experimental condition

and 120 in the control condition.

Waivers are requested in order to (a)

serve children not otherwise eligible for

IV–E (children at risk of but not in foster

care); and (b) provide services not

normally covered by IV–E (substance

abuse assessment, referral and case

management services).

Contact Person: Nancy Rollins,

Division for Children, Youth and

Families, New Hampshire Department

of Health and Human Services, 6 Hazen

Drive, Concord, NH 03301–6522, Phone:

(603) 271–4451, Fax: (603) 271–4729,

Email: nrollins@dhhs.state.us.

State: New Jersey

Description: New Jersey seeks to

implement concurrent permanency

planning and the use of the fost-adopt

model of foster care. In New Jersey, the

average length of stay for children who

are six years old or less with a goal of

adoption is 25 months in their current

placement. The State proposes to use

title IV–E funding for services and

activities designed to reduce to 15

months, the time in foster care

preceding the initiation of termination

of parental rights/initiation of

permanency, for children whose

permanency goal is adoption as

envisioned by the Adoption and Safe

Families Act. The state would hire case

managers specifically dedicated to the

project to apply the permanency reform/

fost-adopt model for both title IV–E

eligible and non-eligible children.

Funds would also be used for enhanced

legal services and substance abuse

services.

The proposed demonstration builds

upon and further elaborates the

permanency reform project underway in

Union, Middlesex and Essex counties

funded by the Children’s Bureau under

the Adoption Opportunities program.

Now completing its second year of a

planned three years of operation, this

program utilizes a variety of methods

including concurrent permanency

planning by child protection and

adoption staff, mediation services,

recruitment and training of special fostadopt homes, and use of post-adoption

counseling therapists to address the

issues of the birth and fost-adopt

families. By building on the curriculum

development, cross training, outreach to

the legal community, and recruitment

and support of fost-adopt homes already

underway, the demonstration project

would facilitate acceleration of the

project schedule to Essex county, which

contributes the largest number of

children to the State’s foster care

caseload.

New Jersey hypothesizes that

allocating case management staff and

other resources to the dedicated units

would reduce foster care costs and

lengths of stay and lead to more

adoptive placements and/or more stable

relative placements than would occur in

the comparison groups over the five

years of the project. Assignment to

comparison groups will be randomized,
37392 Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices

and the evaluation would produce

process and outcome data, as well as

cost/benefit information.

The State requests waivers to permit

the use of title IV–E funds for purposes

not ordinarily eligible for federal

funding, and for children or families

who are not IV–E eligible.

Counties not involved in the project

would serve as the control group, and

after the first year the project would be

extended to other randomly selected

counties.

Contact Person: Michele K. Guhl,

Deputy Commissioner, Division of

Youth and Family Services, P.O. Box

717, Trenton, New Jersey 08625–0717,

Phone: (609) 292–6920, Fax: (609) 984–

0507.

State: New Mexico

Description: The New Mexico project

would provide title IV–E funding as a

direct pass through of federal funds to

identified Tribes, simulating direct

federal funding of Tribes under title IV–

E in order to test this concept. In

addition, the State is proposing the

establishment of a subsidized

guardianship program for Tribal

children, which the State says would

allow permanency while respecting

Tribal customs. The demonstration

project would test both simulated direct

funding and flexible use by Tribes of

IV–E funds.

Currently, title IV–E funding is

extended by the State to five Indian

Tribes through a Joint Powers

Agreement (JPA). The JPA spells out

procedures to be followed in cases of

child abuse and neglect, including how

investigations are to be conducted, how

and when jurisdiction is to be

transferred, and how and when parties

are to be notified. It also provides that

the State would pay Tribes to cover the

foster care maintenance and adoption

assistance for IV–E eligible children in

Tribal custody.

The State proposes a comparison

design for the evaluation. The five

Tribes currently operating under JPA’s

would serve as the comparison sites.

Five additional Tribes would be

selected as the pilot sites. The selection

of the pilot sites would be purposive,

based on the Tribes’ willingness to

participate and their capacity in terms

of the human and material resources

and infrastructure currently in place to

manage the IV–E Program. A five year

project is proposed.

Title IV–E waivers are requested to

allow for the provision of non-recurring

expenses and ongoing assistance

payments for guardians assuming

responsibility in those instances where

Tribal Courts are reluctant to terminate

parental rights, to provide Federal

Financial Participation for individuals

and purposes that are not IV–E eligible.

Contact Person: Maryellen Strawniak,

Acting Director, Protective Services

Division, PO Drawer 5160, Santa Fe,

New Mexico 87502, Phone: (505) 827–

8400, Fax: (505) 827–8480.

State: Oklahoma

Description: Oklahoma proposes a

project to provide assisted guardianship

to the permanency continuum for longterm foster care children for whom

adoption or reunification is not an

option. The goal of the project is

twofold: to determine if quality,

permanency outcomes can be achieved

for these children; and to assess the

impact of providing services, e.g., postplacement services, on achieving these

outcomes.

The State anticipates that assisted

guardianships would provide a

permanency plan option for children in

long-term foster care; alleviate the

financial barriers for persons who desire

to obtain guardianship, thereby

enhancing the prospects of permanency

for these children; and provide stability

for children. In addition, the

demonstration would provide an

opportunity to test the impact of

different levels of services and supports

to children and families served by the

project in achieving quality permanency

outcomes for children. The State also

anticipates that the project would

reduce the workload for child welfare

staff, allowing them time to do

expedited permanency planning for the

remaining children.

The State currently has approximately

1,100 children statewide in long-term

foster care; 15 percent of these children

are Native American. Some of the

Native American children are in the

legal custody of the Department while

others are in tribal custody. The State

estimates that 550 of these children

would be potentially eligible for this

project, with approximately 200

children and families actually served

under the project. The State proposes

three different levels or categories of

services and supports to children and

families who participate in the

demonstration, with each category

having 50–100 children and families

assigned to it. The State would test the

permanency outcomes for children in

relation to the level or category of

services provided to each family. The

State proposes a statewide, five-year

demonstration project.

Oklahoma proposes to randomly

assign children to one of the following:

a control group, which would receive

the current service mix; Target Group I,

which would receive all identified

waiver services and a full range of ongoing post placement services; or Target

Group II which would receive all initial

services included in the waiver, but

limited on-going post placement

services. To assess the project,

Oklahoma proposes to measure

outcomes, processes and cost-benefits.

The State requests waivers of title IV–

E provisions regarding use of title IV–E

funds to pay: a monthly subsidy for

children in guardianship arrangements;

the cost of legal fees required to obtain

guardianship; and the costs of providing

a range of services and supports to

families and children in guardianship

situations (similar to the services

received by adoptive families and

children).

Contact Person: Mike Moore, Division

of Children and Family Services, P.O.

Box 25352, Oklahoma City, OK 73125,

Phone: (405) 522–4487, Fax: (405) 521–

4373.

State: Texas

Description: Texas proposes a Child

Welfare Demonstration project with

three components over five years. The

components affect kinship care,

adoption and Texas’ Permanency

Achieved through Coordinated Efforts

(PACE) project.

First, Texas proposes to implement a

kinship care program as part of

Protective and Regulatory Services

(PRS) and requests a waiver of title IV–

E to utilize otherwise restricted funds

for foster care assistance, in conjunction

with title IV–B funds, to provide upfront

financial assistance and services for

kinship care placements. The state

hypothesizes that if families are

provided financial assistance for the

costs of integrating the child into the

home during the first year of care and

then supplementing caretaker expenses

thereafter to support the child’s care, are

trained, and take part in support groups,

more placements would be made and

would succeed, to the benefit of the

families and children served by PRS.

The length of time in foster care would

decline, freeing up funds devoted both

to staff and foster care maintenance.

Texas proposes to implement the

kinship initiative in El Paso and in

Corpus Christi, Laredo and the Lower

Rio Grande Valley. To evaluate this

component, the State would implement

a matched-group comparison of three

groups: (1) Those that received the

Integration Package, which would

consist of startup money, and the

Training and Services Package; (2) those

that received only the Training and

Services Package; and (3) those that

receive neither package. The state
Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices 37393

would measure: implementation

through qualitative means; process

outcomes through the provision and use

of incentives, provision and use of

services and parenting skills and

knowledge; and outcome through case

flow, duration of time in care, patterns

of disruption and rate of dissolution

and/or re-entry. A cost-benefit analysis

would asses whether the costs of the

demonstration project are justified by

the benefit produced.

The second proposed component of

Texas’ demonstration project is to use

title IV–E funds for the assessment of

prospective adoptive children and

families and to allow for joint training

with Child Placing Agencies (CPA) of

CPA professionals providing adoption

and permanency services. The state’s

hypotheses are that a more

comprehensive assessment would

reduce the disruption and dissolution

rate of PRS adoptions, decrease the

average length of time that children

spend in foster care prior to adoptive

placement, increase satisfaction among

children and families, decrease the

number of placements before placement

in an adoptive home, and increase the

number of children leaving foster care

for placements with adoptive families.

These improvements would speed

permanency and reduce expenditure of

IV–E funds.

Texas proposes to implement this

demonstration project in Harris County,

Houston and the counties surrounding

Houston. To evaluate this project, the

state proposes to compare one region

which would receive an Enhanced

Training condition and an Enhanced

Assessment condition, to other regions

and to statewide historical data. The

evaluation would include

implementation measures of a

qualitative nature; process measures

including pool of potential families,

assessment, quality of placements and

extension of training; and outcome

measures such as case flow, duration of

time in care, patterns of disruption and

rate of dissolution and/or reentry into

the Child Protective Services System. A

cost benefit analysis would assess

whether the costs of the project are

justified by the benefits produced.

The third component of the proposal

is to utilize title IV–E funds flexibly as

part of Phase II of the State’s PACE

project. The state-funded Phase I of

PACE is designed to contract for a

network of private providers to provide

a continuum of services designed to

improve substitute care service and

enhance PRC permanence initiatives.

The State requests a waiver of title IV–

E for Phase II of PACE, to pay for foster

care services and child and family

services on a per-child case rate or

capitated rate, to the network of

providers established in Phase I. PRS

would test the impact of the case rate on

an expansion of service delivery model

that is developed in Phase I.

The state hypothesizes that the new

service delivery system would result in

improved child functioning, increased

stability of placements, shortened

duration of care, reduced rate of return

to foster care, and maintenance of least

restrictive placements. The state

hypothesizes that for Phase II, capitated

rates would result in: cost neutrality, the

ability to provide a case rate for daily

care and supervision reimbursement,

increased incentives for providers to

provide treatment and services to

improve children’s level of care (LOC),

increased ability to provide wraparound

services for children for quicker

movement to permanency or for

placement in the least restrictive

environment and increased incentive to

provide preventive services to lessen the

need for high cost treatment/residential

services. Children would be placed by

random assignment into an equal

number of PRS and Primary Contractor

foster homes.

The state evaluation proposal would

compare the outcomes of four subgroups

of LOC children in PACE Phase II, to

three types of comparison groups:

randomly assigned control groups,

statistically matched cross-sectional

comparison groups, and historical

comparison-sectional comparison. The

state would measure: implementation

through qualitative means; process

through continuity of care, expanded

services and satisfaction with services;

and outcome through change in LOC,

change in level of care domains, change

in rated individual goals, duration of

time, patterns of disruption, rate of

reentry and rate of maltreatment

recurrence. A cost-benefit analysis

would assess whether the costs of the

demonstration project are justified by

the benefits produced.

Contact Persons: Texas Department of

Protective and Regulatory Services, 701

W. 51st Street, P.O. Box 149030, Austin,

TX 78714–9030, Karen Eells (Kinship

Care & Adoption), Judy Rouse (PACE),

Phone: (512) 438–5712, Fax: (512) 438–

3394.

State: Washington

Description: Washington State

proposes to adopt a managed care

approach for services such as mental

health and family preservation to

children who are IV–E eligible and

children who are not. Under the

demonstration project, the State would

make monthly payments for the care of

children with complex needs who have

been screened into the project. These

funds would be pooled with other

resources to contract with local service

providers for oversight of treatment plan

development, implementation,

screening and training. The State

postulates that such coordination

between the State and various local

service providers might result in a better

use of resources, while also providing

individualized and comprehensive

wraparound services. The State hopes

that such an approach would enable it

to tailor services to meet the real needs

of families and children particularly

those children with special needs and

problems.

Washington State would begin the

project in Spokane county and phase in

other counties until a maximum of ten

counties were included in the

demonstration project. The State would

randomly assign children to either the

control or demonstration. The State

proposes to evaluate the project through

random assignment comparison, pre/

post comparison and a cost-benefit

analysis.

The State requests waivers of certain

sections of title IV–E and related

regulations to allow expenditures on

behalf of children and families not

normally eligible under title IV–E, and

to allow expenditures for services not

normally permitted under title IV–E.

The State is also considering the

possibility that it might request a waiver

of title XIX pertaining to Behavioral

Rehabilitation Services.

Contact Person: Tammi Erickson,

Office Chief, Office of Federal Funding

and Victims’ Assistance, State of

Washington Department of Social and

Health Services, P.O. Box 45710,

Olympia, WA 98504–5710, Phone: (360)

902–7936, Fax (360) 902–7903.

State: West Virginia

Description: West Virginia proposes a

school based services project, the Cabell

County Adopt-A-Middle-School project.

The project would provide a variety of

services for children in middle schools

(grades 6, 7, and 8) and their families,

whether or not they would otherwise

qualify for the title IV–E. The purpose

of the service provision is to create a

seamless social support system that

strengthens the ability of children and

families to handle stress affecting their

lives by: facilitating school-based

support for child victims of abuse and

neglect who can be kept in the home

and community; providing early

identification of youth with delinquent

tendencies in order to link the child and

family with services prior to the

initiation of court action; utilizing home
37394 Federal Register / Vol. 63, No. 132 / Friday, July 10, 1998 / Notices

and community-based services

whenever possible; ensuring EPSDT

screening and appropriate treatment for

children in foster care; and assisting the

Department in maintaining linkages

with schools for out-of-home placement,

facilitate return to school for the child

and family, and assist students who are

new to the school district due to foster

or adoptive placements.

To accomplish these services, WV

proposes a two-phase demonstration.

Phase one would pair community social

services agencies with middle schools

in Cabell County as resources for

information, assessments, and referrals.

Phase two proposes the hiring of fulltime prevention coordinators for each

school, beginning with two schools and

phasing in additional schools as

resources permit. Coordinators would

be school-based during the school year,

would serve as initial case managers

and advocates for the child/family,

provide direct services, and provide

follow-up with families over the

summer months.

The State’s hypothesis is that middle

school-based prevention and early

intervention programs would result in a

reduction of the number of children in

foster care, the average expense and

intensity of foster care, and the average

number of days children are in foster

care. This project would be limited to

Cabell County, in southwestern WV,

which includes six middle schools. The

project is proposed to begin in

September 1998 and would run through

August 2003.

The State requests waivers of title IV–

E to permit reimbursement for amounts

expended for children and families and

for purposes that are not normally

eligible under IV–E.

For evaluation purposes, the state

proposes to identify a control-group

county. Outcome measures would

include the number of children entering

foster care, the number of placements in

community-based or family settings,

and the number of days the children are

in foster care. Process evaluation

components include frequency and

types of intervention activities. An

outside evaluator would conduct the

evaluation.

Contact Person: Joan E. Ohl,

Secretary, Department of Health and

Human Resources, Bureau of Children &

Families/Office of Social Services,

Charleston, West Virginia 25305, Phone:

(304) 558–0684, Fax: (304) 558–1130.

Dated: June 25, 1998.

James A. Harrell,

Deputy Commissioner, Administration on

Children, Youth and Families.

[FR Doc. 98–18437 Filed 7–9–98; 8:45 am]

BILLING CODE 4184–01–M

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Food and Drug Administration

[Docket No. 98N–0482]

Agency Information Collection

Activities: Proposed Collection;

Comment Request

AGENCY: Food and Drug Administration,

HHS.

ACTION: Notice.

SUMMARY: The Food and Drug

Administration (FDA) is announcing an

opportunity for public comment on the

proposed collection of certain

information by the agency. Under the

Paperwork Reduction Act of 1995 (the

PRA), Federal agencies are required to

publish notice in the Federal Register

concerning each proposed collection of

information, including each proposed

extension of an existing collection of

information, and to allow 60 days for

public comment in response to the

notice. This notice solicits comments on

information collection provisions

relating to the regulation of FDA’s

adverse experience reporting (AER) for

licensed biological products and general

records.

DATES: Submit written comments on the

collections of information by September

8, 1998.

ADDRESSES: Submit written comments

on the collections of information to the

Dockets Management Branch (HFA–

305), Food and Drug Administration,

5630 Fishers Lane, rm. 1061, Rockville,

MD 20852. All comments should be

identified with the docket number

found in brackets in the heading of this

document.

FOR FURTHER INFORMATION CONTACT:

Jonnalynn P. Capezzuto, Office of

Information Resources Management

(HFA–250), Food and Drug

Administration, 5600 Fishers Lane,

Rockville, MD 20857, 301–827–4659.

SUPPLEMENTARY INFORMATION: Under the

PRA (44 U.S.C. 3501–3520), Federal

agencies must obtain approval from the

Office of Management and Budget

(OMB) for each collection of

information they conduct or sponsor.

‘‘Collection of information’’ is defined

in 44 U.S.C. 3502(3) and 5 CFR

1320.3(c) and includes agency requests

or requirements that members of the

public submit reports, keep records, or

provide information to a third party.

Section 3506(c)(2)(A) of the PRA (44

U.S.C. 3506(c )(2)(A)) requires Federal

agencies to provide a 60-day notice in

the Federal Register concerning each

proposed collection of information

before submitting the collection to OMB

for approval. To comply with this

requirement, FDA is publishing notice

of the proposed collections of

information listed below.

With respect to the following

collection of information, FDA invites

comments on: (1) Whether the proposed

collection of information is necessary

for the proper performance of FDA’s

functions, including whether the

information will have practical utility;

(2) the accuracy of FDA’s estimate of the

burden of the proposed collection of

information, including the validity of

the methodology and assumptions used;

(3) ways to enhance the quality, utility,

and clarity of the information to be

collected; and (4) ways to minimize the

burden of the collection of information

on respondents, including through the

use of automated collection techniques,

when appropriate, and other forms of

information technology.

Adverse Experience Reporting for

Licensed Biological Products—21 CFR

600.80, 600.81, and 600.90; and General

Records—21 CFR 600.12 (OMB Control

Number 0910–0308)—Extension

Under the Public Health Service Act

(42 U.S.C. 262), FDA is required to

ensure the marketing of only those

biological products that are safe and

effective. FDA must therefore be

informed of all adverse experiences

occasioned by the use of licensed

biological products. FDA issued the

adverse experience reporting

requirements to enable FDA to take

actions necessary for the protection of

the public health in response to reports

of adverse experiences related to

licensed biological products. The

primary purpose of FDA’s adverse

experience reporting system is to flag

potentially serious safety problems with

licensed biological products, focusing

especially on newly licensed products.

Although premarket testing discloses a

general safety profile of a new drug’s

comparatively common adverse effects,

the larger and more diverse patient

populations exposed to the licensed

biological product provides the

opportunity to collect information on

rare, latent, and long-term effects.

Reports are obtained from a variety of

sources, including patients, physicians,

foreign regulatory agencies, and clinical

investigators. Information derived from